| NPI | 1114411246 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM MD2020-1186) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM RS2018-0573) |
| Enumeration Date | 2018-06-21 |
| Last Update Date | 2025-03-19 |