| NPI | 1407433360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2024015222) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL83525) |
| Enumeration Date | 2021-03-26 |
| Last Update Date | 2025-10-02 |