| NPI | 1386791879 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 64138) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 200400230) |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2025-07-03 |