| NPI | 1023234424 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PR 7088) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PR 7088) |
| 207Q00000X Family Medicine (Licence: MI 4301064743) | |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2012-12-10 |