| NPI | 1629714654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID 7471540) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID MRM-2152) |
| Enumeration Date | 2022-05-11 |
| Last Update Date | 2025-07-08 |