| NPI | 1285892117 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D73661)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A140118)  | 
| 207Q00000X Family Medicine (Licence: NC 148913)  | |
| Enumeration Date | 2008-05-28 | 
| Last Update Date | 2025-02-12 |