| NPI | 1649585670 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 278408-1) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD60399355) |
| Enumeration Date | 2010-08-14 |
| Last Update Date | 2015-06-19 |