| NPI | 1992115737 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D86562) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MS 62923) |
| Enumeration Date | 2014-05-02 |
| Last Update Date | 2021-06-19 |