| NPI | 1497118178 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 88143) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 68279) |
| Enumeration Date | 2016-03-31 |
| Last Update Date | 2023-01-14 |