| NPI | 1548262330 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D38829) |
| Additional Taxonomies | 208600000X Surgery (Licence: MD D38829) |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2016-01-29 |