| NPI | 1225477094 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME155343) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL TRN18615) |
| 207Q00000X Family Medicine (Licence: GA 074991) | |
| Enumeration Date | 2013-06-14 |
| Last Update Date | 2023-01-18 |