| NPI | 1356155410 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ND 201923) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL 1-182635) |
| Enumeration Date | 2025-02-06 |
| Last Update Date | 2025-08-13 |