| NPI | 1770584070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS013170) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PA OS013170) |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2013-09-25 |