| NPI | 1356968408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D96928) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 8718) |
| Enumeration Date | 2020-07-05 |
| Last Update Date | 2023-06-27 |