| NPI | 1912486176 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID O-1430) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID MRO-1829) |
| Enumeration Date | 2018-08-08 |
| Last Update Date | 2022-11-08 |