| NPI | 1386930808 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0116023948) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0102203443) |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2013-07-31 |