| NPI | 1770161218 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 99633) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2026023181) |
| Enumeration Date | 2021-03-29 |
| Last Update Date | 2026-06-01 |