| NPI | 1154740454 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 58998) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101261914) |
| 207Q00000X Family Medicine (Licence: OH 35130444) | |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2025-02-06 |