| NPI | 1891215257 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA DO-05610) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-10967) |
| Enumeration Date | 2017-06-26 |
| Last Update Date | 2023-12-21 |