| NPI | 1134143753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101263722) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 36387) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2023-05-25 |