| NPI | 1407416357 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 5101026772) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5151013750) |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2022-07-22 |