| NPI | 1669516035 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2007-00044) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO dr.0054938) |
| Enumeration Date | 2007-02-17 |
| Last Update Date | 2022-03-22 |