| NPI | 1205254158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 300564) |
| Additional Taxonomies | 208D00000X General Practice (Licence: LA 300564) |
| Enumeration Date | 2014-03-28 |
| Last Update Date | 2023-05-10 |