| NPI | 1063049989 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 94681) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2021-02730) |
| Enumeration Date | 2020-03-23 |
| Last Update Date | 2026-07-23 |