| NPI | 1215344734 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL 131407) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PR 13,471-I) |
| Enumeration Date | 2014-07-16 |
| Last Update Date | 2024-02-22 |