| NPI | 1457702862 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 83342) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL39374) |
| Enumeration Date | 2016-06-27 |
| Last Update Date | 2024-04-03 |