| NPI | 1831577196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MT MED-PHYS-LIC-117581) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR 189802) |
| Enumeration Date | 2015-05-07 |
| Last Update Date | 2025-07-22 |