| NPI | 1235208380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME77667) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 049119) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2015-01-08 |