| NPI | 1871172718 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 83616) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL83616) |
| Enumeration Date | 2021-04-07 |
| Last Update Date | 2025-08-06 |