| NPI | 1982829628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS10810) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101015926) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2020-05-21 |