| NPI | 1831650316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 22667) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 5011654) |
| Enumeration Date | 2019-03-27 |
| Last Update Date | 2022-03-02 |