| NPI | 1083399364 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101283656) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0116037984) |
| Enumeration Date | 2023-06-15 |
| Last Update Date | 2025-07-16 |