| NPI | 1578909347 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME121353) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 076490) |
| 207Q00000X Family Medicine (Licence: VA 0101265105) | |
| Enumeration Date | 2013-05-20 |
| Last Update Date | 2022-08-01 |