| NPI | 1790955185 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 235959) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 4656) |
| 207Q00000X Family Medicine (Licence: CO DR.0051499) | |
| Enumeration Date | 2008-03-03 |
| Last Update Date | 2024-09-16 |