| NPI | 1427012327 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM MD2018-0727) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 47270-20) |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2025-05-12 |