| NPI | 1407204225 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD225168) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 31592) |
| 207Q00000X Family Medicine (Licence: ID MRM-1587) | |
| 207Q00000X Family Medicine (Licence: ID M-13950) | |
| Enumeration Date | 2016-06-02 |
| Last Update Date | 2025-08-18 |