| NPI | 1144633819 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2017023058) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2014016673) |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2022-07-21 |