| NPI | 1841602943 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 338934) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2019003293) |
| Enumeration Date | 2014-05-22 |
| Last Update Date | 2025-01-29 |