| NPI | 1386771814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GU M1699) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101042540) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2019-07-25 |