| NPI | 1255798260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD61000139) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: NY P97165) |
| Enumeration Date | 2016-01-21 |
| Last Update Date | 2026-06-18 |