| NPI | 1154571313 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL DO1207) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL L.2981) |
| 207Q00000X Family Medicine (Licence: AL MD.30572) | |
| Enumeration Date | 2008-09-24 |
| Last Update Date | 2020-09-22 |