| NPI | 1255397105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 9601208) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: NC 96-01208) |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2025-06-13 |