| NPI | 1891354916 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 77118) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2019039838) |
| Enumeration Date | 2019-06-12 |
| Last Update Date | 2022-10-25 |