| NPI | 1306585245 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA DO-06933) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-12574) |
| Enumeration Date | 2022-05-31 |
| Last Update Date | 2025-08-04 |