| NPI | 1710907324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101241061) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D0060208) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2019-06-05 |