| NPI | 1235499724 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 068149) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL OS11048) |
| Enumeration Date | 2012-05-18 |
| Last Update Date | 2012-08-02 |