| NPI | 1477849784 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS15952) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0102204070) |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2022-08-08 |