| NPI | 1295715704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: NC 9800784) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: VA 0101057835) |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2021-12-21 |