| NPI | 1558687582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2014030571) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 04-28297) |
| Enumeration Date | 2010-04-15 |
| Last Update Date | 2026-04-20 |