| NPI | 1144742958 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101279272) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2022-03066) |
| Enumeration Date | 2017-07-13 |
| Last Update Date | 2024-07-10 |