| NPI | 1992365670 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 390200000X) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101283725) |
| Enumeration Date | 2019-06-16 |
| Last Update Date | 2024-09-12 |