| NPI | 1679214654 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 5315232202) | 
| Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: MI 4351049197) | 
| Enumeration Date | 2022-04-05 | 
| Last Update Date | 2025-06-24 |