| NPI | 1821449521 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 45235) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-10692) |
| Enumeration Date | 2016-06-24 |
| Last Update Date | 2021-10-08 |