| NPI | 1497825178 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MT 11740) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MT 11770) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2025-01-13 |