| NPI | 1821730011 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 82862-20) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WI 82862-20) |
| Enumeration Date | 2022-04-08 |
| Last Update Date | 2025-09-30 |