| NPI | 1033668157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 268989) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ZZ 114431) |
| Enumeration Date | 2016-09-30 |
| Last Update Date | 2017-04-19 |