| NPI | 1578533345 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV 21674) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101238081) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2008-07-29 |