| NPI | 1407273865 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 103986) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 53871) |
| Enumeration Date | 2014-03-24 |
| Last Update Date | 2026-08-25 |