| NPI | 1164168191 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID MRM-2157) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM MD2025-0771) |
| Enumeration Date | 2022-05-11 |
| Last Update Date | 2025-09-08 |