| NPI | 1730613332 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2023-01541) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 40784) |
| Enumeration Date | 2017-04-20 |
| Last Update Date | 2023-11-03 |