| NPI | 1245793058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID 3071849) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10066945) |
| Enumeration Date | 2019-04-09 |
| Last Update Date | 2025-05-15 |