| NPI | 1396472163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4351049291) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5315232407) |
| Enumeration Date | 2022-08-02 |
| Last Update Date | 2025-10-02 |