| NPI | 1962994434 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2023043177) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS021702) |
| 207Q00000X Family Medicine (Licence: KS 0548490) | |
| Enumeration Date | 2018-05-31 |
| Last Update Date | 2023-12-01 |