| NPI | 1083065064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0102207707) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 7732) |
| Enumeration Date | 2016-06-30 |
| Last Update Date | 2023-05-30 |