| NPI | 1821220062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty (Licence: TN 68798) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CO DR.0062432) |
| 405300000X Prevention Professional (Licence: IL 036102300) | |
| Enumeration Date | 2009-08-21 |
| Last Update Date | 2025-03-31 |