| NPI | 1396974911 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301095194) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5315042397) |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2009-07-02 |