| NPI | 1760689491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101251913) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WV 23288) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2022-04-06 |