| NPI | 1649337767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101233048) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D0059584) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2021-04-02 |