| NPI | 1225651912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA DO-06273) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-11853) |
| Enumeration Date | 2020-05-28 |
| Last Update Date | 2023-12-21 |