| NPI | 1669486155 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60834504) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA VA0101237234) |
| 207Q00000X Family Medicine (Licence: SC 39957) | |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2018-12-11 |