| NPI | 1174291926 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX 1050077) |
| Additional Taxonomies | 2083B0002X Preventive Medicine Obesity Medicine (Licence: TX 1050077) |
| Enumeration Date | 2021-09-04 |
| Last Update Date | 2021-09-04 |