| NPI | 1003077538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D0079494) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 201101170) |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2015-09-08 |