| NPI | 1699738880 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 40732) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WV 26581) |
| 207Q00000X Family Medicine (Licence: IN 01055006A) | |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2017-12-07 |