| NPI | 1982018123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID O-0891) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 14192491-1204) |
| Enumeration Date | 2014-06-16 |
| Last Update Date | 2025-02-24 |