| NPI | 1871170761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2024-01316) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL 50656) |
| 207Q00000X Family Medicine (Licence: AR E-16284) | |
| 207Q00000X Family Medicine (Licence: SC 91288) | |
| Enumeration Date | 2021-03-26 |
| Last Update Date | 2025-02-19 |