| NPI | 1275194441 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0024178168) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 5011934) |
| Enumeration Date | 2019-06-27 |
| Last Update Date | 2021-05-14 |