| NPI | 1912600610 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 1912600610) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ME 1912600610) |
| Enumeration Date | 2023-03-23 |
| Last Update Date | 2025-12-16 |