| NPI | 1265403968 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101225500) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 30462) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2017-01-30 |