| NPI | 1396144507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD13797) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: OR MD13797) |
| Enumeration Date | 2014-08-14 |
| Last Update Date | 2014-08-14 |