| NPI | 1124434600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: HI MD-23251) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AK 119841) |
| 207Q00000X Family Medicine (Licence: MN 78167) | |
| Enumeration Date | 2014-07-07 |
| Last Update Date | 2025-12-23 |