| NPI | 1356507990 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 01012385) |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health (Licence: CA 131430) |
| Enumeration Date | 2008-08-04 |
| Last Update Date | 2023-11-27 |