| NPI | 1952863086 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD61491391) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY TP216) |
| Enumeration Date | 2019-04-06 |
| Last Update Date | 2024-02-02 |