| NPI | 1487822425 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 67209) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 52578) |
| Enumeration Date | 2008-02-12 |
| Last Update Date | 2015-08-21 |