| NPI | 1710474655 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 66237) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 29054) |
| Enumeration Date | 2018-04-17 |
| Last Update Date | 2024-03-17 |