| NPI | 1689893018 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: FL OS-8610) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 3007) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2011-05-23 |