| NPI | 1306911797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA MD.206740) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MS 18317) |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2018-08-17 |