| NPI | 1124381140 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101257746) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MT 66769) |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2022-07-19 |