| NPI | 1154941847 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME161899) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2022-02665) |
| 207Q00000X Family Medicine (Licence: VA 0101278232) | |
| Enumeration Date | 2020-04-22 |
| Last Update Date | 2023-11-21 |