| NPI | 1831534866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NE 30816) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SD 10441) |
| Enumeration Date | 2013-05-03 |
| Last Update Date | 2020-11-28 |