| NPI | 1265883466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 79196) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 79196) |
| Enumeration Date | 2016-06-29 |
| Last Update Date | 2018-12-26 |