| NPI | 1730568262 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID M-13445) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID MRM-1470) |
| Enumeration Date | 2015-05-29 |
| Last Update Date | 2023-12-15 |