| NPI | 1457566796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101241453) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: DC MD037855) |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2022-11-09 |