| NPI | 1588811269 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD170757) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM RS20080413) |
| Enumeration Date | 2008-08-25 |
| Last Update Date | 2020-08-26 |