| NPI | 1629019724 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL MD.33738) |
| Additional Taxonomies | 261QR1300X Clinic/Center, Rural Health (Licence: MD.33738) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2025-06-20 |