| NPI | 1780639468 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2006018666) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 216491) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2022-06-03 |