| NPI | 1912580127 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID O-1770) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID MRO-2051) |
| Enumeration Date | 2021-05-05 |
| Last Update Date | 2024-07-08 |