| NPI | 1154810323 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 26257) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2018000680) |
| Enumeration Date | 2018-05-03 |
| Last Update Date | 2025-09-29 |