| NPI | 1194014621 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME113623) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL TR15398) |
| Enumeration Date | 2011-04-05 |
| Last Update Date | 2020-06-30 |