| NPI | 1447607056 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL 175957) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 62683) |
| 207Q00000X Family Medicine (Licence: MS 30248) | |
| Enumeration Date | 2016-05-24 |
| Last Update Date | 2025-09-26 |