| NPI | 1902858483 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G87379) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036-101304) |
| 207Q00000X Family Medicine (Licence: AL 18516) | |
| 207Q00000X Family Medicine (Licence: MO 2000148102) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2025-06-02 |