| NPI | 1235834342 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301514147) | 
| Additional Taxonomies | 208D00000X General Practice (Licence: MI 4301514147) | 
| 207V00000X Obstetrics & Gynecology (Licence: MI 4351051311) | |
| Enumeration Date | 2023-03-31 | 
| Last Update Date | 2025-10-01 |