| NPI | 1760833115 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NE 31109) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 7780) |
| Enumeration Date | 2016-06-28 |
| Last Update Date | 2019-08-16 |