| NPI | 1720260367 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101277505) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 237215) |
| Enumeration Date | 2007-12-05 |
| Last Update Date | 2023-03-02 |