| NPI | 1972942829 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 6998) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ R2290) |
| Enumeration Date | 2013-06-24 |
| Last Update Date | 2019-07-16 |