| NPI | 1720375199 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2020-03236) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA MD-42819) |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2023-06-09 |