| NPI | 1598800047 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PR 12350) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: FL ACN807) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2020-03-03 |