| NPI | 1982618369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NE 504) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL OS23364) |
| 207Q00000X Family Medicine (Licence: VA 0102209724) | |
| 207Q00000X Family Medicine (Licence: PA OS025496C) | |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2026-09-27 |