| NPI | 1104311554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PR 22045) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 22045) |
| Enumeration Date | 2018-06-28 |
| Last Update Date | 2024-09-09 |