| NPI | 1871079855 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 61240) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL61240) |
| Enumeration Date | 2018-07-13 |
| Last Update Date | 2021-01-07 |