| NPI | 1649707597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS16569) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 0006854) |
| Enumeration Date | 2017-05-22 |
| Last Update Date | 2024-01-18 |