| NPI | 1174261283 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 87656) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL87656) |
| Enumeration Date | 2022-05-27 |
| Last Update Date | 2025-10-10 |