| NPI | 1437847365 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0024186933) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 5023217) |
| Enumeration Date | 2023-04-27 |
| Last Update Date | 2025-11-02 |