| NPI | 1619405859 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2023-01229) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 81731) |
| Enumeration Date | 2017-06-01 |
| Last Update Date | 2023-09-05 |