| NPI | 1023844818 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: NC F09240378) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: NC F09240378) |
| Enumeration Date | 2024-09-10 |
| Last Update Date | 2024-09-12 |