| NPI | 1013142850 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0102204194) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 4932) |
| Enumeration Date | 2009-05-22 |
| Last Update Date | 2017-02-16 |