| NPI | 1114505559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 13007561-1205) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 04-51321) |
| Enumeration Date | 2021-03-29 |
| Last Update Date | 2025-07-09 |