| NPI | 1639433691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0116028424) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ R73583) |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2018-09-20 |