| NPI | 1235375007 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0102202803) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT012545) |
| Enumeration Date | 2008-12-30 |
| Last Update Date | 2013-10-08 |