| NPI | 1194394668 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2024-03437) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0116035576) |
| Enumeration Date | 2021-06-21 |
| Last Update Date | 2025-07-10 |