| NPI | 1861849580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 85674) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL MD36325) |
| Enumeration Date | 2016-05-23 |
| Last Update Date | 2021-09-17 |