| NPI | 1639198856 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 28885) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 071270) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2023-08-18 |