| NPI | 1336355494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 238462) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 229054) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2020-03-08 |