| NPI | 1477511764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 36335) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME 94625) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2024-02-16 |