| NPI | 1477728962 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 252429) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD443883) |
| Enumeration Date | 2008-04-25 |
| Last Update Date | 2012-07-16 |