| NPI | 1780260240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR DO219689) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 83541) |
| Enumeration Date | 2021-03-23 |
| Last Update Date | 2024-07-01 |