| NPI | 1770658718 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101047581) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D0071907) |
| 207Q00000X Family Medicine (Licence: DC MD040064) | |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2021-05-31 |