| NPI | 1700058435 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MT MED-PHYS-LIC-12016) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WY 14513A) |
| Enumeration Date | 2008-04-02 |
| Last Update Date | 2025-12-30 |