| NPI | 1770132698 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 96278) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL 44910) |
| Enumeration Date | 2019-09-04 |
| Last Update Date | 2023-10-25 |