| NPI | 1043740202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2020009910) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WY 12327A) |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2026-03-02 |