| NPI | 1316234958 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 072547) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital |
| Enumeration Date | 2011-07-04 |
| Last Update Date | 2016-04-21 |