| NPI | 1265804520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM DO-2023-0181) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 008670) |
| 207Q00000X Family Medicine (Licence: MA 280884) | |
| Enumeration Date | 2015-10-27 |
| Last Update Date | 2025-07-01 |