| NPI | 1942994439 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SD 0752) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-12854) |
| Enumeration Date | 2023-06-07 |
| Last Update Date | 2023-06-07 |