| NPI | 1801864590 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 28077) |
| Additional Taxonomies | 208D00000X General Practice (Licence: AZ 28077) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2025-03-18 |