| NPI | 1902478597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 24305) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MS 28389) |
| Enumeration Date | 2021-07-13 |
| Last Update Date | 2026-05-28 |