| NPI | 1215551296 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS18537) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR DO225636) |
| Enumeration Date | 2020-06-04 |
| Last Update Date | 2025-09-23 |