| NPI | 1972130243 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 95993) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 260752) |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2023-07-19 |