| NPI | 1851324941 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AK 5844) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0102201341) |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2021-10-25 |