| NPI | 1023398237 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA 002111) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA 05008134L) |
| Enumeration Date | 2011-08-18 |
| Last Update Date | 2011-08-18 |