| NPI | 1477797967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101252016) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 261321) |
| Enumeration Date | 2009-04-28 |
| Last Update Date | 2023-01-13 |