| NPI | 1407490600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 5012600) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 5012600) |
| Enumeration Date | 2019-10-30 |
| Last Update Date | 2025-05-28 |