| NPI | 1083186332 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0001218998) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0024177161) |
| Enumeration Date | 2018-12-27 |
| Last Update Date | 2019-01-16 |