| NPI | 1669405395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301055222) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: MI 4301055222) |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2015-11-16 |