| NPI | 1912483157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SD 12992) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND RL15048) |
| Enumeration Date | 2018-07-11 |
| Last Update Date | 2022-04-25 |