| NPI | 1649233743 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME10937) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 10937) |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2025-08-06 |