| NPI | 1881754349 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD R105387) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: MD R105387) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2018-01-23 |