| NPI | 1265008247 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA DO-06285) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-12086) |
| Enumeration Date | 2021-06-01 |
| Last Update Date | 2025-07-29 |