| NPI | 1265811335 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 37365) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL37635) |
| Enumeration Date | 2015-05-22 |
| Last Update Date | 2022-06-17 |