| NPI | 1831686369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 93547) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 2075) |
| Enumeration Date | 2018-04-19 |
| Last Update Date | 2025-05-07 |