| NPI | 1184005761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 82591) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5.10E09) |
| Enumeration Date | 2015-06-09 |
| Last Update Date | 2019-09-26 |