| NPI | 1134168545 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 000115) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA DO000115) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2023-05-04 |