| NPI | 1023271954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2014-02372) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 51536) |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2023-11-14 |