| NPI | 1588923411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SD 17252) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 6669) |
| Enumeration Date | 2012-05-12 |
| Last Update Date | 2025-07-22 |