| NPI | 1417125907 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA MD.206804) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2010020876) |
| Enumeration Date | 2008-02-18 |
| Last Update Date | 2022-07-28 |