| NPI | 1801007026 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 064372) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 141591) |
| Enumeration Date | 2007-05-28 |
| Last Update Date | 2012-02-13 |