| NPI | 1184936742 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0102203582) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 2539) |
| Enumeration Date | 2010-07-11 |
| Last Update Date | 2017-02-15 |