| NPI | 1710248653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 183218) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: NC 183218) |
| Enumeration Date | 2012-06-07 |
| Last Update Date | 2026-07-27 |