| NPI | 1205860681 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0102201385) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0102201385) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2013-11-19 |