| NPI | 1013390665 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL MD.36066) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL 4155) |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2020-10-22 |