| NPI | 1780884163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PR 16814) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 16814) |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2017-03-08 |