| NPI | 1912499286 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 009959) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME154910) |
| Enumeration Date | 2018-06-03 |
| Last Update Date | 2022-06-14 |