| NPI | 1912498981 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA MD446659) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-11146) |
| Enumeration Date | 2018-05-24 |
| Last Update Date | 2025-12-23 |