| NPI | 1043531197 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 39919) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-8971) |
| Enumeration Date | 2010-06-11 |
| Last Update Date | 2012-08-14 |