| NPI | 1730950395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: DC CA2100012506) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD C0009769) |
| 207Q00000X Family Medicine (Licence: VA 0110009788) | |
| Enumeration Date | 2024-01-12 |
| Last Update Date | 2025-12-01 |