| NPI | 1578149043 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 103804) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL TRN33656) |
| 207Q00000X Family Medicine (Licence: FL ME158822) | |
| Enumeration Date | 2021-03-23 |
| Last Update Date | 2025-05-12 |