| NPI | 1609004936 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2013-01090) |
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: NC 2013-01090) |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2021-08-17 |