| NPI | 1215458443 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 6930) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 335624) |
| Enumeration Date | 2017-06-28 |
| Last Update Date | 2025-08-25 |