| NPI | 1124564778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: VA 0024194747) |
| Additional Taxonomies | 251E00000X Home Health |
| Enumeration Date | 2017-01-06 |
| Last Update Date | 2025-09-29 |