| NPI | 1720427222 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 52219) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ R74133) |
| Enumeration Date | 2013-06-18 |
| Last Update Date | 2021-06-21 |