| NPI | 1437243391 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101244831) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301081699) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2022-11-14 |