| NPI | 1396126454 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NH 20566) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NH RT2841) |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2020-07-27 |