| NPI | 1902388184 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD221549) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 58734) |
| Enumeration Date | 2018-09-04 |
| Last Update Date | 2025-09-05 |