| NPI | 1477059723 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ND 21372) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 64484) |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2024-10-26 |