| NPI | 1376034751 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 91691) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036174227) | 
| 207Q00000X Family Medicine (Licence: WA ML60866880) | |
| 207Q00000X Family Medicine (Licence: GA 91691) | |
| Enumeration Date | 2018-05-22 | 
| Last Update Date | 2025-05-29 |