| NPI | 1457931149 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC LL83546) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC MDO.83546) |
| Enumeration Date | 2021-04-08 |
| Last Update Date | 2025-02-26 |