| NPI | 1780695437 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SD 7085) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA 3747) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2013-03-08 |