| NPI | 1265014922 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2025-00838) |
| Additional Taxonomies | 207QD0401X (Licence: NC 2025-00838) |
| Enumeration Date | 2021-04-22 |
| Last Update Date | 2026-03-18 |