| NPI | 1982341525 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NH 38057) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5151015757) |
| Enumeration Date | 2022-05-16 |
| Last Update Date | 2025-07-15 |