| NPI | 1003175589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101260555) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D0080145) |
| 207Q00000X Family Medicine (Licence: PA MD453807) | |
| Enumeration Date | 2012-05-03 |
| Last Update Date | 2023-10-25 |