| NPI | 1275712333 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101245954) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2007-01497) |
| Enumeration Date | 2007-10-25 |
| Last Update Date | 2013-03-27 |