| NPI | 1649653197 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2020-02838) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 7861) |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2025-08-05 |