| NPI | 1235876863 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2025024066) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2022021160) |
| Enumeration Date | 2022-05-16 |
| Last Update Date | 2025-09-04 |