| NPI | 1679214654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: MI 4301518318) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301518318) |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2026-09-08 |