| NPI | 1619254141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 2588) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL OS11509) |
| Enumeration Date | 2011-11-11 |
| Last Update Date | 2015-01-21 |