| NPI | 1942706387 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 93525) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA 329132) |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2023-10-18 |