| NPI | 1497922819 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME117131) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ 12345) |
| Enumeration Date | 2008-05-14 |
| Last Update Date | 2026-07-23 |