| NPI | 1215386800 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 78755) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL TPME4914) | 
| 207Q00000X Family Medicine (Licence: IL 036167275) | |
| Enumeration Date | 2016-06-06 | 
| Last Update Date | 2025-01-14 |