| NPI | 1821031295 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: AR c8434) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AR C8434) |
| 251S00000X Community/Behavioral Health (Licence: AR c8434) | |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2025-06-03 |