| NPI | 1093205213 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP61450605) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ME DO3364) |
| 207Q00000X Family Medicine (Licence: ID OC-0302) | |
| Enumeration Date | 2018-05-14 |
| Last Update Date | 2025-10-27 |