| NPI | 1619919933 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID M 7149) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID m7149) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2014-08-07 |