| NPI | 1962104091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS21770) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL UO8972) |
| Enumeration Date | 2023-03-21 |
| Last Update Date | 2025-03-24 |