| NPI | 1699707984 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 9227) |
| Additional Taxonomies | 261QA1903X Clinic/Center Ambulatory Surgical |
| 261QE0002X Clinic/Center Emergency Care | |
| 261QI0500X Clinic/Center Infusion Therapy | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| 261QP2000X Clinic/Center Physical Therapy | |
| 261QP3300X Clinic/Center Pain | |
| 291U00000X Clinical Medical Laboratory (Licence: PR 40D07100418) | |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2011-06-08 |