| NPI | 1053999458 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 100539) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL OS19551) |
| Enumeration Date | 2021-03-30 |
| Last Update Date | 2025-10-01 |