| NPI | 1952961872 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 009770) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2019018921) |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2023-10-19 |