| NPI | 1568800639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NH 17783) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 66106) |
| Enumeration Date | 2013-06-11 |
| Last Update Date | 2024-12-01 |