| NPI | 1659722411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 39358) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL39358) |
| Enumeration Date | 2016-06-23 |
| Last Update Date | 2021-02-22 |