| NPI | 1871122184 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2022-01785) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 93046) |
| Enumeration Date | 2020-04-07 |
| Last Update Date | 2025-03-31 |