| NPI | 1730479379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101252495) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD179159) |
| 207Q00000X Family Medicine (Licence: DC MD040975) | |
| 207Q00000X Family Medicine (Licence: TX S-5879) | |
| Enumeration Date | 2011-04-16 |
| Last Update Date | 2021-09-23 |