| NPI | 1871614370 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 0000043713) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 059427) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2023-11-09 |