| NPI | 1053722686 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 54554) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ R74404) |
| Enumeration Date | 2014-05-16 |
| Last Update Date | 2024-01-09 |