| NPI | 1336375955 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2017-01601) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0102203137) |
| 207Q00000X Family Medicine (Licence: SC LL1258) | |
| Enumeration Date | 2009-06-10 |
| Last Update Date | 2021-08-10 |