| NPI | 1841265550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 200301191) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0102201482) |
| 207Q00000X Family Medicine (Licence: NY 211390) | |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2008-01-22 |