| NPI | 1669443602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MD D0018362) |
| Additional Taxonomies | 174400000X Specialist (Licence: MD D18362) |
| Enumeration Date | 2006-01-28 |
| Last Update Date | 2019-06-25 |