| NPI | 1114781630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 234133) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: LA 234133) |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: LA 234133) | |
| Enumeration Date | 2024-02-07 |
| Last Update Date | 2024-11-06 |