| NPI | 1154959211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2024-02342) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 93345) |
| Enumeration Date | 2020-04-01 |
| Last Update Date | 2025-01-08 |