| NPI | 1851555361 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101254860) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 249330) |
| Enumeration Date | 2008-07-14 |
| Last Update Date | 2022-11-28 |