| NPI | 1255913125 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MT MED-PHYS-LIC-158484) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 2929) |
| Enumeration Date | 2021-04-21 |
| Last Update Date | 2025-09-03 |