| NPI | 1194909465 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL 106010) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PR 11843-I) |
| 207Q00000X Family Medicine (Licence: PR 26910-R) | |
| 207Q00000X Family Medicine (Licence: PR 27653-R) | |
| Enumeration Date | 2007-12-21 |
| Last Update Date | 2020-06-17 |