| NPI | 1821295882 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 048819) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 9406837) |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2010-09-07 |