| NPI | 1023347010 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 63147) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA08695200) |
| 207Q00000X Family Medicine (Licence: GA 63883) | |
| Enumeration Date | 2009-12-22 |
| Last Update Date | 2025-10-13 |