| NPI | 1831683150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101267510) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0116031656) |
| Enumeration Date | 2018-06-20 |
| Last Update Date | 2021-08-30 |