| NPI | 1720865538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT F09230122) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CT 12484) |
| Enumeration Date | 2023-09-14 |
| Last Update Date | 2024-07-02 |