| NPI | 1932306503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 50-01-009367) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 29556) |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2007-07-08 |