| NPI | 1255906681 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 341243) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL86130) |
| Enumeration Date | 2021-05-27 |
| Last Update Date | 2024-10-22 |