| NPI | 1184061954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ R73838) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 52114) |
| Enumeration Date | 2013-06-03 |
| Last Update Date | 2016-05-22 |