| NPI | 1952528291 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AK 5980) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101044532) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2007-07-08 |