| NPI | 1871222398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 102736) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 13755) |
| Enumeration Date | 2022-06-09 |
| Last Update Date | 2025-09-16 |