| NPI | 1649388596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 53596) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 23088) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2020-04-13 |