| NPI | 1891779385 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 36179) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101015339) |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2025-12-16 |