| NPI | 1164170429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: NC 5016111) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 11018704) |
| Enumeration Date | 2022-03-16 |
| Last Update Date | 2026-04-28 |