| NPI | 1053368043 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS8053) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL DO.2613) |
| 207Q00000X Family Medicine (Licence: KY TP664) | |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2022-04-19 |