| NPI | 1891780052 |
|---|---|
| Other Name | NA NA NA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 22412) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 20-T6531) |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2025-06-18 |