| NPI | 1518904515 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SD 4447) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 28953) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2017-02-11 |