| NPI | 1982353660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC MMD.87702) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NC 202402323) |
| Enumeration Date | 2022-03-21 |
| Last Update Date | 2024-08-29 |