| NPI | 1336529247 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NE 1998) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL UO 4615) |
| 207Q00000X Family Medicine (Licence: FL OS14547) | |
| Enumeration Date | 2015-06-05 |
| Last Update Date | 2019-06-05 |