| NPI | 1689704074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA 139872) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 42752) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2016-02-23 |