| NPI | 1588854277 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0116019630) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0102202372) |
| Enumeration Date | 2007-07-28 |
| Last Update Date | 2024-04-23 |