| NPI | 1811209687 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME124180) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 47985) |
| Enumeration Date | 2010-07-09 |
| Last Update Date | 2023-01-20 |