| NPI | 1770779332 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MS 22936) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL L2886R) |
| 207Q00000X Family Medicine (Licence: AL L.3071R) | |
| 207Q00000X Family Medicine (Licence: VA 0101246908) | |
| Enumeration Date | 2007-09-18 |
| Last Update Date | 2024-08-05 |