| NPI | 1518221506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VT 042.0015126) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ R73584) |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2022-10-31 |