| NPI | 1710515366 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2025013998) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MO 2025013998) |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2025-07-28 |