| NPI | 1851690234 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 83312) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA 60535969) |
| 207Q00000X Family Medicine (Licence: PA MD450619) | |
| Enumeration Date | 2011-03-24 |
| Last Update Date | 2019-11-05 |