| NPI | 1619036639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA 0A000205L) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT018039) |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2026-01-16 |