| NPI | 1013059245 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-32896) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME103318) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2021-04-21 |