| NPI | 1720435019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS16047) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VI 3422) |
| Enumeration Date | 2016-05-17 |
| Last Update Date | 2025-04-01 |