| NPI | 1811516230 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4351046117) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301508980) |
| Enumeration Date | 2020-04-15 |
| Last Update Date | 2023-06-20 |