| NPI | 1285996868 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101258342) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT202228) |
| 207Q00000X Family Medicine (Licence: MD D0079755) | |
| Enumeration Date | 2012-06-11 |
| Last Update Date | 2021-02-01 |