| NPI | 1568751824 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: VA 0101271796) |
| Additional Taxonomies | 208D00000X General Practice (Licence: OH 35.123674) |
| 208D00000X General Practice (Licence: NH 21260) | |
| 208D00000X General Practice (Licence: FL TPME3162) | |
| 208D00000X General Practice (Licence: NY 320959) | |
| 208D00000X General Practice (Licence: MA 1014384) | |
| 208D00000X General Practice (Licence: PA MD469713) | |
| Enumeration Date | 2011-04-06 |
| Last Update Date | 2023-06-16 |