| NPI | 1376956466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 5101022945) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX R1723) |
| 207Q00000X Family Medicine (Licence: VA 0102204318) | |
| Enumeration Date | 2014-06-05 |
| Last Update Date | 2025-03-10 |