| NPI | 1578122289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101285050) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA 331546) |
| Enumeration Date | 2019-06-07 |
| Last Update Date | 2025-11-18 |