| NPI | 1598053654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 99655) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME138400) |
| Enumeration Date | 2011-07-11 |
| Last Update Date | 2024-12-12 |