| NPI | 1750482733 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101243389) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 27332) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2017-11-15 |