| NPI | 1043750474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: MI 7501010094) |
| Additional Taxonomies | 302R00000X Health Maintenance Organization (Licence: MI 2701370194) |
| Enumeration Date | 2017-03-04 |
| Last Update Date | 2017-03-04 |