| NPI | 1619916020 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS11206) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 200501199) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2024-10-11 |