| NPI | 1447562095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101272287) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD162201) |
| 207Q00000X Family Medicine (Licence: PA MT197698) | |
| Enumeration Date | 2010-07-12 |
| Last Update Date | 2021-10-22 |