| NPI | 1164082004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 92243) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL82807) |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2022-07-06 |