| NPI | 1306862388 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID O-1192) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR DO25595) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2025-05-05 |