| NPI | 1508508185 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2026-03426) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL90006) |
| Enumeration Date | 2022-04-12 |
| Last Update Date | 2026-08-04 |