| NPI | 1760560288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 27655) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 054278) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2016-08-10 |