| NPI | 1104053891 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0102203141) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 5527) |
| Enumeration Date | 2009-06-19 |
| Last Update Date | 2024-01-11 |