| NPI | 1114368024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: NE 1254) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 1254) |
| Enumeration Date | 2013-07-09 |
| Last Update Date | 2023-08-16 |