| NPI | 1366880742 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0102203930) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0116026023) |
| Enumeration Date | 2013-06-07 |
| Last Update Date | 2016-09-02 |