| NPI | 1497917298 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2011-01001) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 30967) |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2012-10-02 |