| NPI | 1487617213 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101256887) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM 20020483) |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2019-10-02 |