| NPI | 1841849791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 302R00000X Health Maintenance Organization |
| Enumeration Date | 2019-09-04 |
| Last Update Date | 2019-09-04 |