| NPI | 1982134805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101289637) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D89795) |
| Enumeration Date | 2017-06-13 |
| Last Update Date | 2026-07-15 |