| NPI | 1770046831 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 261QP2400X Clinic/Center, Prison Health (Licence: CA A186300) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A186300) |
| Enumeration Date | 2019-04-07 |
| Last Update Date | 2026-03-16 |