| NPI | 1235543794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: MA 270083) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL TRN 19940) |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2022-07-21 |