| NPI | 1043499445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 16879) |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services (Licence: PR 16879) |
| Enumeration Date | 2007-11-01 |
| Last Update Date | 2014-08-15 |