| NPI | 1407343528 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2023-00819) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 1.079078-DO) |
| Enumeration Date | 2018-04-14 |
| Last Update Date | 2025-06-13 |