| NPI | 1659323186 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 40649) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME94611) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2023-10-04 |