| NPI | 1619311396 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS12374) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 2854) |
| 207Q00000X Family Medicine (Licence: FL UO3361) | |
| Enumeration Date | 2013-04-24 |
| Last Update Date | 2024-01-09 |