| NPI | 1225273469 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA 61185876) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 255656-1) |
| Enumeration Date | 2008-12-02 |
| Last Update Date | 2022-09-23 |