| NPI | 1962083337 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301511083) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4351047903APP21) |
| Enumeration Date | 2021-04-17 |
| Last Update Date | 2024-07-24 |