| NPI | 1881007482 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NE 28679) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NE 28679) |
| Enumeration Date | 2014-06-11 |
| Last Update Date | 2025-07-30 |