| NPI | 1962059402 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA RN231252) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: GA RN231252) |
| Enumeration Date | 2019-08-20 |
| Last Update Date | 2019-08-20 |