| NPI | 1871522920 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AK 6245) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 36960) |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2015-05-28 |