| NPI | 1578792289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 41250) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-8756) |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2025-07-15 |