| NPI | 1336182997 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0102204809) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NH 12309) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2020-04-21 |