| NPI | 1447367891 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QV0200X Clinic/Center, VA (Licence: PR 7799) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: PR 7799) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2007-07-08 |