| NPI | 1528932092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MS 907796) |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care (Licence: MS 907796) |
| Enumeration Date | 2025-09-30 |
| Last Update Date | 2025-09-30 |