| NPI | 1699962175 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: CA G86894) |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services (Licence: FL ME91427) |
| Enumeration Date | 2007-09-28 |
| Last Update Date | 2007-09-28 |