| NPI | 1629697636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: GA 104863) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: FL ME170215) |
| Enumeration Date | 2020-04-09 |
| Last Update Date | 2025-08-12 |