| NPI | 1295297638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301514377) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA 333248) |
| Enumeration Date | 2019-04-04 |
| Last Update Date | 2025-09-17 |