| NPI | 1861724098 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 238629) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 229877) |
| Enumeration Date | 2010-02-15 |
| Last Update Date | 2014-01-13 |