| NPI | 1841466703 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 249103) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 41550) |
| Enumeration Date | 2008-05-01 |
| Last Update Date | 2008-07-03 |