| NPI | 1558041103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| 261QU0200X Clinic/Center, Urgent Care | |
| Enumeration Date | 2023-07-19 |
| Last Update Date | 2024-09-13 |