| NPI | 1659807410 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 85074) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 40940) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2020-08-06 |