| NPI | 1144254582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO R7N57) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NV DO2754) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2026-01-07 |