| NPI | 1174145304 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME158234) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA 338808) |
| 207Q00000X Family Medicine (Licence: AZ 1908R77909) | |
| Enumeration Date | 2020-05-11 |
| Last Update Date | 2025-07-16 |