| NPI | 1578877700 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101254945) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101254945) |
| Enumeration Date | 2010-07-29 |
| Last Update Date | 2020-05-12 |