| NPI | 1396747077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 73024) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME81369) |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2015-04-28 |