| NPI | 1659325306 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS 5130) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MS 14114) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2025-05-23 |