| NPI | 1558408880 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101052826) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D0048074) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2021-06-09 |