| NPI | 1891056123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 90560) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL UO 3231) |
| 207Q00000X Family Medicine (Licence: FL OS12642) | |
| Enumeration Date | 2012-06-04 |
| Last Update Date | 2023-12-14 |