| NPI | 1982124244 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35143595) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: RI LP04112) |
| 207Q00000X Family Medicine (Licence: LA 322666) | |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2022-07-26 |