| NPI | 1982868865 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2014-01439) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301092909) |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2014-08-14 |