| NPI | 1609080803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QA0505X Family Medicine Adult Medicine (Licence: PR 2643) |
| Additional Taxonomies | 302R00000X Health Maintenance Organization (Licence: PR 2634) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2023-03-07 |