| NPI | 1255488557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 005119) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R-7684) |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2008-12-30 |