| NPI | 1386331684 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 5101028803) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5151016057APP23) | 
| Enumeration Date | 2023-04-18 | 
| Last Update Date | 2025-06-24 |