| NPI | 1720467590 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: GA 82883) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL TRN 21212) |
| 207Q00000X Family Medicine (Licence: GA 82883) | |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2022-06-21 |