| NPI | 1316108640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NH 14864) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0116019086) |
| 207Q00000X Family Medicine (Licence: MA 243165) | |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2019-03-18 |