| NPI | 1275194607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PR 22242) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 15115-I) |
| Enumeration Date | 2019-06-26 |
| Last Update Date | 2023-06-08 |