| NPI | 1891362661 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA DO-06272) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-12166) |
| Enumeration Date | 2021-06-09 |
| Last Update Date | 2026-02-26 |