| NPI | 1649589664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID O-1059) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR DO172063) |
| Enumeration Date | 2010-09-26 |
| Last Update Date | 2024-07-10 |