| NPI | 1396078663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL 116222) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL 116222) |
| Enumeration Date | 2009-09-17 |
| Last Update Date | 2019-09-25 |