| NPI | 1013141902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 46909) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME112557) |
| Enumeration Date | 2009-05-07 |
| Last Update Date | 2015-11-05 |