| NPI | 1275894529 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0102206685) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL OS12721) |
| Enumeration Date | 2012-06-04 |
| Last Update Date | 2021-08-18 |