| NPI | 1760442859 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 22809) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 22089) |
| 207Q00000X Family Medicine (Licence: NM 86292) | |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2020-01-02 |