| NPI | 1801449673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 4689) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 82957) |
| Enumeration Date | 2019-07-22 |
| Last Update Date | 2022-08-15 |