| NPI | 1578083283 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2020-02551) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0116030881) |
| Enumeration Date | 2017-06-23 |
| Last Update Date | 2022-07-21 |