| NPI | 1568991388 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 1568991388) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101023322) |
| Enumeration Date | 2017-06-06 |
| Last Update Date | 2026-03-29 |