| NPI | 1740339738 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ND 11115) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AK 5197) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2010-06-17 |