| NPI | 1730317835 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0102203150) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0116021723) |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2018-03-16 |