| NPI | 1629106679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QX0100X Clinic/Center, Occupational Medicine (Licence: MA 157551) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: MA 157551) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2010-03-30 |