| NPI | 1639585359 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NE 28764) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA 44298) |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2025-04-17 |