| NPI | 1861056137 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 88444) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 250814) |
| Enumeration Date | 2019-04-23 |
| Last Update Date | 2023-03-22 |