| NPI | 1497728588 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY 61503) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: HI 12632) |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2026-02-25 |