| NPI | 1285954867 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA MD.206003) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT197201) |
| Enumeration Date | 2010-06-07 |
| Last Update Date | 2019-08-21 |