| NPI | 1013646876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 99011) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM MD2026-0253) |
| 207R00000X Internal Medicine (Licence: NM MD2026-0253) | |
| Enumeration Date | 2022-06-07 |
| Last Update Date | 2026-06-19 |