| NPI | 1912321332 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 104986) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 36511) |
| Enumeration Date | 2014-02-05 |
| Last Update Date | 2025-08-15 |