| NPI | 1225000862 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 9300830) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 04-39634) |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2025-10-22 |