| NPI | 1538545132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: MI L265059) |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services (Licence: MI L265059) |
| Enumeration Date | 2015-08-05 |
| Last Update Date | 2015-08-05 |