| NPI | 1114040870 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 234864) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD MD30012) |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2009-10-19 |