| NPI | 1518472588 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: DC RN1044808) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC F10171409) |
| Enumeration Date | 2017-12-12 |
| Last Update Date | 2019-04-04 |