| NPI | 1962965129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 73836) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 7963) |
| Enumeration Date | 2019-04-12 |
| Last Update Date | 2023-12-18 |