| NPI | 1982268645 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: DC DO210001355) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL82126) | 
| Enumeration Date | 2019-04-29 | 
| Last Update Date | 2022-09-07 |