| NPI | 1578942405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 208261) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2018-01149) |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2025-11-21 |