| NPI | 1932595162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 010602) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NH 18687) |
| Enumeration Date | 2015-04-14 |
| Last Update Date | 2025-06-06 |