| NPI | 1740691062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 202103251) |
| Additional Taxonomies | 207QB0002X Family Medicine, Bariatric Medicine (Licence: NC 202103251) |
| Enumeration Date | 2014-05-09 |
| Last Update Date | 2026-05-19 |