| NPI | 1689231458 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC LL82147)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: DE C2-0024046)  | 
| Enumeration Date | 2019-05-28 | 
| Last Update Date | 2022-08-02 |