| NPI | 1992969976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL LL752) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME84720) |
| Enumeration Date | 2008-07-18 |
| Last Update Date | 2022-07-21 |