| NPI | 1205215894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2022-02983) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101261920) |
| Enumeration Date | 2015-05-28 |
| Last Update Date | 2024-02-29 |