| NPI | 1639327919 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME124202) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA C159879) |
| 207Q00000X Family Medicine (Licence: TN 58517) | |
| 207Q00000X Family Medicine (Licence: OH 35.136011) | |
| 207Q00000X Family Medicine (Licence: DE C1-0013634) | |
| Enumeration Date | 2008-08-29 |
| Last Update Date | 2025-10-14 |