| NPI | 1104878065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD MD047674) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D44855) |
| 207P00000X Emergency Medicine (Licence: VA 0101237027) | |
| 207Q00000X Family Medicine (Licence: VA 0101237027) | |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2026-05-19 |