| NPI | 1902284128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS13313) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 82576) |
| 207Q00000X Family Medicine (Licence: OH 34.013707) | |
| 207Q00000X Family Medicine (Licence: TN 3616) | |
| 207Q00000X Family Medicine (Licence: DE C2-0013132) | |
| Enumeration Date | 2015-05-07 |
| Last Update Date | 2022-10-21 |