| NPI | 1083875868 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 26967) |
| Additional Taxonomies | 174400000X Specialist (Licence: AL 26967) |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2022-05-24 |