| NPI | 1386202612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 101543) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0116032629) |
| Enumeration Date | 2019-06-02 |
| Last Update Date | 2024-12-27 |