| NPI | 1366645814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101244665) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D0077681) |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2020-11-20 |