| NPI | 1285209296 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID MRM-2045) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 13821094-1205) |
| Enumeration Date | 2021-05-21 |
| Last Update Date | 2024-10-29 |