| NPI | 1700443991 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301506672) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4351044526) |
| Enumeration Date | 2019-05-22 |
| Last Update Date | 2022-12-07 |