| NPI | 1326785254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID 2771530) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID MRM-2166) |
| Enumeration Date | 2022-05-12 |
| Last Update Date | 2025-07-09 |