| NPI | 1659786796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NE 28915) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 7318) |
| Enumeration Date | 2014-06-27 |
| Last Update Date | 2026-03-02 |