| NPI | 1093922197 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101239912) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WV 22742) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2012-12-27 |