| NPI | 1124589890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0102207107) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL OS19498) |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2023-05-10 |