| NPI | 1134611742 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 26513) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 286831) |
| Enumeration Date | 2018-05-31 |
| Last Update Date | 2025-11-06 |