| NPI | 1912161050 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2020-04605) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101240811) |
| Enumeration Date | 2008-07-17 |
| Last Update Date | 2024-02-06 |