| NPI | 1265525992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 41581) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA MD-51579) |
| 207Q00000X Family Medicine (Licence: WY 16355A) | |
| 207Q00000X Family Medicine (Licence: NE 32043) | |
| 207Q00000X Family Medicine (Licence: MO 2023017838) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2026-05-25 |