| NPI | 1740622596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 008902) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 3662) |
| Enumeration Date | 2013-07-22 |
| Last Update Date | 2022-05-26 |