| NPI | 1689801672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0102203125) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL4758) |
| Enumeration Date | 2009-06-17 |
| Last Update Date | 2023-03-23 |