| NPI | 1649373580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 265252) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PR 14725) |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2016-08-23 |