| NPI | 1295942688 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 034351) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS-006602-L) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2017-03-15 |