| NPI | 1366692592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101254354) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD439374) |
| Enumeration Date | 2008-09-24 |
| Last Update Date | 2022-02-08 |