| NPI | 1215936281 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101033570) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 31476) |
| 207Q00000X Family Medicine (Licence: NC 67071) | |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2022-06-21 |