| NPI | 1710411400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV DO2971) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS020763) |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2022-10-13 |