| NPI | 1841276284 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL 58520) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL 14420) |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2019-01-30 |