| NPI | 1649243445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 41339) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101252696) |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2022-09-17 |