| NPI | 1972999720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD188925) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2016-02401) |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2023-04-18 |