| NPI | 1063035814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QB0002X Family Medicine, Bariatric Medicine (Licence: NC 202300683) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT019941) |
| Enumeration Date | 2020-05-27 |
| Last Update Date | 2024-07-23 |