| NPI | 1568697415 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101254457) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2012-00268) |
| Enumeration Date | 2009-05-21 |
| Last Update Date | 2017-03-24 |