| NPI | 1376809665 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 78767) |
| Additional Taxonomies | 207QA0000X Family Medicine Adolescent Medicine (Licence: GA 78767) |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2024-05-27 |