| NPI | 1720508021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS20608) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2020017659) |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2026-03-10 |