| NPI | 1285845917 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ND 11293) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND RL10595) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2025-09-24 |