| NPI | 1760697411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101246795) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT184117) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2021-08-17 |