| NPI | 1891957353 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 83947) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME106882) |
| 207Q00000X Family Medicine (Licence: FL TRN12292) | |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2019-11-01 |