| NPI | 1033645189 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA MD-46492) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-10812) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2020-08-24 |