| NPI | 1083064026 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS22822) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 278717) |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2025-12-12 |