| NPI | 1255077483 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WY 18915C) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID M-17782) |
| Enumeration Date | 2022-05-10 |
| Last Update Date | 2025-11-19 |