| NPI | 1962884015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 007694) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0116028550) |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2026-01-28 |