| NPI | 1326501479 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA R-13616) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 71314) |
| Enumeration Date | 2019-04-07 |
| Last Update Date | 2025-06-11 |