| NPI | 1649366451 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D0050938) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101268604) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2025-05-29 |