| NPI | 1598134322 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 4630) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MT 76404) |
| Enumeration Date | 2015-09-22 |
| Last Update Date | 2022-08-02 |