| NPI | 1245410836 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 083016) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS 016463) |
| 207Q00000X Family Medicine (Licence: VA 0102204866) | |
| Enumeration Date | 2007-11-12 |
| Last Update Date | 2026-02-03 |