| NPI | 1528268307 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 53796-20) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 5379620) |
| 207Q00000X Family Medicine (Licence: GA 002488) | |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2020-05-19 |