| NPI | 1043715295 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 102496) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 66429) |
| Enumeration Date | 2018-03-29 |
| Last Update Date | 2025-05-05 |