| NPI | 1942654207 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 307423) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MS 34225) |
| Enumeration Date | 2016-04-22 |
| Last Update Date | 2025-05-14 |