| NPI | 1992805592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301065666) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301035666) |
| Enumeration Date | 2006-09-23 |
| Last Update Date | 2018-05-23 |