| NPI | 1457468043 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: PR 13345) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PR 13345) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2013-05-08 |