| NPI | 1003622242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| 261QI0500X Clinic/Center, Infusion Therapy | |
| Enumeration Date | 2024-12-03 |
| Last Update Date | 2024-12-03 |