| NPI | 1316571912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 100027) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 21702) |
| Enumeration Date | 2020-02-24 |
| Last Update Date | 2024-09-11 |