| NPI | 1093765521 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 055484) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL 26227) |
| 207Q00000X Family Medicine (Licence: LA 199994) | |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2007-07-08 |