| NPI | 1992744098 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PR 11114) |
| Additional Taxonomies | 174400000X Specialist (Licence: PR 11114) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2016-04-30 |