| NPI | 1992064109 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NE 27850) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 6670) |
| Enumeration Date | 2012-05-08 |
| Last Update Date | 2016-05-25 |