| NPI | 1649566423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0102-203739) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0116023873) |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2020-12-11 |