| NPI | 1831153824 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 112737) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 04-28795) |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2023-12-05 |