| NPI | 1255912937 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA MD-52909) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 81162) |
| Enumeration Date | 2021-04-15 |
| Last Update Date | 2025-09-17 |