| NPI | 1497312219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2022-01869) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL82222) |
| Enumeration Date | 2019-05-28 |
| Last Update Date | 2025-05-29 |