| NPI | 1164180543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: FL APRN11016509) |
| Additional Taxonomies | 207QA0000X Family Medicine, Adolescent Medicine (Licence: FL APRN11016509) |
| Enumeration Date | 2021-12-02 |
| Last Update Date | 2021-12-02 |