| NPI | 1477885127 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL 1063) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PR 17763) |
| Enumeration Date | 2010-02-05 |
| Last Update Date | 2019-01-02 |