| NPI | 1831688647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM MD2022-1484) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 63273) |
| Enumeration Date | 2018-05-07 |
| Last Update Date | 2023-01-13 |