| NPI | 1083293104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM F03211422) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM 63661) |
| Enumeration Date | 2021-04-06 |
| Last Update Date | 2021-08-17 |