| NPI | 1740296532 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 48965) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2006037232) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2023-03-08 |