| NPI | 1811564057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD218627) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0116035317) |
| Enumeration Date | 2021-06-07 |
| Last Update Date | 2024-09-30 |