| NPI | 1033597679 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D84754)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101264856)  | 
| 207Q00000X Family Medicine (Licence: DC MD045918)  | |
| Enumeration Date | 2015-05-15 | 
| Last Update Date | 2022-01-08 |