| NPI | 1487276796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL LE173333) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 75143) |
| Enumeration Date | 2020-05-08 |
| Last Update Date | 2025-09-26 |