| NPI | 1568628527 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101249977) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0116020317) |
| Enumeration Date | 2008-07-30 |
| Last Update Date | 2022-11-14 |