| NPI | 1164476420 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS8171) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: NC 2007-01509) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2025-08-12 |