| NPI | 1215375340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 87233) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AK 117118) |
| 207Q00000X Family Medicine (Licence: NC 2016-01535) | |
| Enumeration Date | 2013-06-11 |
| Last Update Date | 2026-05-13 |