| NPI | 1124692827 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2024-02329) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 322717) |
| Enumeration Date | 2021-05-17 |
| Last Update Date | 2025-07-10 |