| NPI | 1104314509 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101278323) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD474955) |
| Enumeration Date | 2018-05-01 |
| Last Update Date | 2023-05-16 |