| NPI | 1811154594 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA MD-204213) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: HI MD-15672) |
| 207Q00000X Family Medicine (Licence: NY 913) | |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2024-08-12 |