| NPI | 1851735971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 57910) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101260518) |
| Enumeration Date | 2013-04-19 |
| Last Update Date | 2023-09-20 |