| NPI | 1013982859 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101255978) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 22338) |
| 207Q00000X Family Medicine (Licence: IA 35947) | |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2015-01-14 |