| NPI | 1982620787 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID M6276) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID MR-0868) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2011-11-08 |