| NPI | 1811962095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101238338) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D0105144) |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2025-10-22 |