| NPI | 1770548893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D0053640) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101269960) |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2021-11-11 |