| NPI | 1790058782 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 006379) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0116024037) |
| Enumeration Date | 2012-02-21 |
| Last Update Date | 2025-01-05 |