| NPI | 1740854025 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 84097) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND 00000000000) |
| Enumeration Date | 2021-05-19 |
| Last Update Date | 2024-09-04 |