| NPI | 1174573927 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA MD-56142) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD27736) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2025-12-04 |