| NPI | 1619137726 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: DC MD036845) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MD D0067860) |
| 208D00000X General Practice (Licence: DE C1-0009715) | |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2020-07-10 |