| NPI | 1144293713 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101266007) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 98-00293) |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2020-02-20 |