| NPI | 1174724082 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101259796) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D0084118) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2022-06-09 |