| NPI | 1033770078 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301506163) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4351044633) |
| Enumeration Date | 2019-06-20 |
| Last Update Date | 2022-01-29 |