| NPI | 1275026411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0116031845) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2026-02155) |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2026-08-10 |