| NPI | 1780179812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 52075) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL52075) |
| Enumeration Date | 2018-07-01 |
| Last Update Date | 2021-08-09 |