| NPI | 1093794257 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 18843) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101052898) |
| Enumeration Date | 2006-01-15 |
| Last Update Date | 2022-07-12 |