| NPI | 1336218304 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 53961) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 41406) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2025-01-02 |