| NPI | 1326309121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME164822) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 074554) |
| 207Q00000X Family Medicine (Licence: SC LL34544) | |
| Enumeration Date | 2012-06-07 |
| Last Update Date | 2024-03-22 |