| NPI | 1760433205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NH 16922) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0102203059) |
| 207Q00000X Family Medicine (Licence: WA OP00002069) | |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2021-06-29 |