| NPI | 1962665497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 005562) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ R70147) |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2024-06-20 |