| NPI | 1265429963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 023401) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA MD.023401) |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2024-04-15 |