| NPI | 1922538503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2020-03659) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 228149) |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2026-06-05 |