| NPI | 1982283297 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 77298) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 9171) |
| Enumeration Date | 2021-04-05 |
| Last Update Date | 2025-03-13 |