| NPI | 1306604798 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246Z00000X Specialist/Technologist, Other |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: CT 654) |
| Enumeration Date | 2024-03-11 |
| Last Update Date | 2025-08-21 |