| NPI | 1922341148 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS15323) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 267109) |
| Enumeration Date | 2013-04-06 |
| Last Update Date | 2018-11-20 |