| NPI | 1700413150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2024024620) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC MMD.83962) |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2024-08-05 |