| NPI | 1376034751 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 91691) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA ML60866880) |
| 207Q00000X Family Medicine (Licence: GA 91691) | |
| Enumeration Date | 2018-05-22 |
| Last Update Date | 2022-08-12 |