| NPI | 1801813845 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM MD2024-0740) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 54451-020) |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2024-07-19 |