| NPI | 1659467744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301074527) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 42575) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2008-07-29 |