| NPI | 1669673000 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD175364) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101243697) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2025-08-28 |