| NPI | 1811628365 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2025028090) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2022022188) |
| Enumeration Date | 2022-06-23 |
| Last Update Date | 2025-07-14 |