| NPI | 1669418067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101239325) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 40686) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2012-07-27 |