| NPI | 1033329842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID O-0630) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101016969) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2012-11-28 |