| NPI | 1750024055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 47171) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4351052145) |
| Enumeration Date | 2022-04-15 |
| Last Update Date | 2026-04-29 |