| NPI | 1922334044 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D0059256) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101058726) |
| Enumeration Date | 2009-10-23 |
| Last Update Date | 2009-10-23 |