| NPI | 1427672633 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 96106)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL84151)  | 
| Enumeration Date | 2020-06-03 | 
| Last Update Date | 2023-09-06 |