| NPI | 1336588599 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS14489) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101020753) |
| Enumeration Date | 2013-06-21 |
| Last Update Date | 2022-07-21 |