| NPI | 1508941501 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 31294) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 031294) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2021-01-05 |