| NPI | 1629053699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA A98050) |
| Additional Taxonomies | 208D00000X General Practice (Licence: HI MD-12052) |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2007-12-06 |