| NPI | 1265726244 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2014-01407) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 173154) |
| 207Q00000X Family Medicine (Licence: VA 0101255706) | |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2021-07-30 |