| NPI | 1679244156 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID F09210398) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID 69809) |
| Enumeration Date | 2021-09-23 |
| Last Update Date | 2021-10-08 |