| NPI | 1275744153 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0102203940) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0116017530) |
| 207Q00000X Family Medicine (Licence: NC 2009-00749) | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2022-08-12 |