| NPI | 1053515338 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 063358) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 141367) |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2015-03-17 |