| NPI | 1790917052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 52163) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND PT12461) |
| 207Q00000X Family Medicine (Licence: ND RL11228) | |
| Enumeration Date | 2009-08-19 |
| Last Update Date | 2023-11-17 |