| NPI | 1366650525 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: DC MD039037) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D006899) |
| 207Q00000X Family Medicine (Licence: DE C1-0009546) | |
| Enumeration Date | 2007-05-20 |
| Last Update Date | 2018-04-09 |