| NPI | 1366899643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101264387) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL TRN22887) |
| Enumeration Date | 2016-05-17 |
| Last Update Date | 2022-08-04 |