| NPI | 1124406012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 282NW0100X General Acute Care Hospital, Women |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2015-05-11 |