| NPI | 1033417522 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 81721) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: MI 51010119542) |
| Enumeration Date | 2011-03-07 |
| Last Update Date | 2026-04-06 |