| NPI | 1184784787 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101044897) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D0044744) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2021-05-27 |