| NPI | 1811145253 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101246330) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: WV 26372) |
| 207Q00000X Family Medicine (Licence: WV 26372) | |
| 207Q00000X Family Medicine (Licence: TX Q2791) | |
| Enumeration Date | 2008-08-27 |
| Last Update Date | 2021-02-28 |