| NPI | 1790892479 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D0065032) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: DC MD039579) |
| 207Q00000X Family Medicine (Licence: VA 0101249697) | |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2011-12-14 |