| NPI | 1356540124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS 14253) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 629) |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2017-01-23 |