| NPI | 1144969833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL 1-148575) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL F05220831) |
| Enumeration Date | 2022-06-01 |
| Last Update Date | 2022-06-07 |