| NPI | 1275858797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MT 79625) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WY 14529A) |
| Enumeration Date | 2010-03-29 |
| Last Update Date | 2025-07-09 |