| NPI | 1457840068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID 7371563) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY C3972) |
| Enumeration Date | 2018-05-09 |
| Last Update Date | 2025-08-27 |