| NPI | 1821667932 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NE 37320) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-12200) |
| Enumeration Date | 2021-06-22 |
| Last Update Date | 2026-05-27 |