| NPI | 1902487770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PR 022223) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PR 22223) |
| Enumeration Date | 2021-04-14 |
| Last Update Date | 2021-04-14 |