| NPI | 1326208117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2011-00037) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0116020657) |
| Enumeration Date | 2008-06-15 |
| Last Update Date | 2023-12-12 |