| NPI | 1912490954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR DO217538) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2019030226) |
| Enumeration Date | 2018-06-13 |
| Last Update Date | 2023-12-26 |