| NPI | 1306907803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D0028076) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101034431) |
| 207Q00000X Family Medicine (Licence: DC MDO38336) | |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2011-11-02 |