| NPI | 1700466182 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 83727-20) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 83727-20) |
| 207Q00000X Family Medicine (Licence: FL ME176557) | |
| 207Q00000X Family Medicine (Licence: OH 35.154796) | |
| Enumeration Date | 2021-04-10 |
| Last Update Date | 2025-10-27 |