| NPI | 1376835215 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2016022195) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 51941) |
| 207Q00000X Family Medicine (Licence: VA 0101256105) | |
| Enumeration Date | 2011-05-11 |
| Last Update Date | 2022-07-21 |