| NPI | 1174973424 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS022842) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0116029508) |
| Enumeration Date | 2016-06-17 |
| Last Update Date | 2023-11-13 |