| NPI | 1063973675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL 20210) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL 2448) |
| Enumeration Date | 2019-03-27 |
| Last Update Date | 2025-04-17 |