| NPI | 1871013631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 22243) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE TEP8002) |
| 207Q00000X Family Medicine (Licence: TX S8456) | |
| Enumeration Date | 2017-06-22 |
| Last Update Date | 2022-07-11 |