| NPI | 1871553313 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ND 10745) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA 3656) |
| 207Q00000X Family Medicine (Licence: MN 50211) | |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2023-05-15 |