| NPI | 1093277220 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 71694) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD210992) |
| Enumeration Date | 2019-04-05 |
| Last Update Date | 2025-01-08 |