| NPI | 1396941852 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0102203489) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 056823) |
| 207Q00000X Family Medicine (Licence: CA 20A12354) | |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2020-02-07 |