| NPI | 1649765132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: MD R115328) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WV APRN86960) |
| Enumeration Date | 2018-06-27 |
| Last Update Date | 2025-06-19 |