| NPI | 1780744193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101243749) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 39565 020) |
| 207Q00000X Family Medicine (Licence: MD D0072943) | |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2022-02-07 |