| NPI | 1619929817 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 049588) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 200501942) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2019-10-16 |