| NPI | 1386026466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2024041690) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR E-11248) |
| 207Q00000X Family Medicine (Licence: NV 22189) | |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2026-03-28 |