| NPI | 1679766752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101243767) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 001714) |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2022-12-28 |