| NPI | 1023002730 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 46860) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 046860) |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2019-05-15 |