| NPI | 1659346955 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 200201452) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101234595) |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2021-09-08 |