| NPI | 1982191920 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD227820) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301506395) |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2026-01-18 |