| NPI | 1639558216 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD187370) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0116027761) |
| Enumeration Date | 2015-05-28 |
| Last Update Date | 2018-09-05 |