| NPI | 1417646969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 81611) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 100348) |
| Enumeration Date | 2023-05-02 |
| Last Update Date | 2025-05-19 |