| NPI | 1710567235 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301511087) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4351047659) |
| Enumeration Date | 2021-04-09 |
| Last Update Date | 2024-10-04 |