| NPI | 1508359837 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101268406) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0116031599) |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2023-03-01 |