| NPI | 1366228942 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PR 449-E) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PR 1786-PA) |
| Enumeration Date | 2023-09-07 |
| Last Update Date | 2026-08-11 |