| NPI | 1689724676 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA MD-53031) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 21590) |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2025-10-30 |