| NPI | 1831400605 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2012-02177) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC DO1640) |
| Enumeration Date | 2010-06-28 |
| Last Update Date | 2025-10-01 |