| NPI | 1013578608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 5101026334) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI BP10069235) |
| Enumeration Date | 2019-06-24 |
| Last Update Date | 2026-06-11 |