| NPI | 1194176446 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 82079) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 008576) |
| Enumeration Date | 2016-06-28 |
| Last Update Date | 2021-01-15 |