| NPI | 1306580881 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MS 35157) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 6352) |
| Enumeration Date | 2022-04-21 |
| Last Update Date | 2025-09-04 |