| NPI | 1265753669 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 5050) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA 04472) |
| Enumeration Date | 2010-06-20 |
| Last Update Date | 2025-09-03 |