| NPI | 1033406657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MT 34287) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 4049) |
| Enumeration Date | 2011-07-03 |
| Last Update Date | 2015-11-25 |