| NPI | 1932768959 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 82009) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-11543) |
| Enumeration Date | 2019-06-12 |
| Last Update Date | 2025-10-02 |