| NPI | 1851885628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM 2024-0131) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 61796) |
| Enumeration Date | 2018-06-15 |
| Last Update Date | 2024-10-25 |