| NPI | 1922534684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS17012) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT017572) |
| Enumeration Date | 2017-05-02 |
| Last Update Date | 2023-03-07 |