| NPI | 1750321220 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D0055146) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD490238C) |
| 207Q00000X Family Medicine (Licence: KY C4011) | |
| 207Q00000X Family Medicine (Licence: WI 13585-320) | |
| 207Q00000X Family Medicine (Licence: VA 0101222399) | |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2025-07-01 |