| NPI | 1710555974 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID O-1911) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-12232) |
| Enumeration Date | 2021-06-15 |
| Last Update Date | 2024-07-09 |