| NPI | 1215436845 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 88747) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL UO6319) |
| Enumeration Date | 2018-02-09 |
| Last Update Date | 2025-10-23 |