| NPI | 1932147402 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME132028) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036-102337) |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2018-03-17 |