| NPI | 1831752450 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OL61429594) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL UO7283) |
| Enumeration Date | 2019-04-18 |
| Last Update Date | 2023-07-06 |