| NPI | 1487069985 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NE 1564) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2014020089) |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2021-08-24 |