| NPI | 1871160382 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 99075) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 167562) |
| Enumeration Date | 2021-06-04 |
| Last Update Date | 2024-05-29 |