| NPI | 1922568443 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD209139) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 11887200-1205) |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2025-10-23 |