| NPI | 1487173050 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101269770) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 9557) |
| Enumeration Date | 2017-09-15 |
| Last Update Date | 2020-08-07 |