| NPI | 1821166273 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101278279) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME0060787) |
| Enumeration Date | 2006-12-02 |
| Last Update Date | 2023-04-20 |