| NPI | 1720418841 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 079288) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL TRN16318) |
| Enumeration Date | 2013-11-26 |
| Last Update Date | 2019-10-17 |