| NPI | 1629385976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 42765) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ 42765) |
| Enumeration Date | 2010-09-08 |
| Last Update Date | 2010-09-08 |