| NPI | 1083026207 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL MD42916) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME129512) |
| Enumeration Date | 2014-05-22 |
| Last Update Date | 2024-07-03 |