| NPI | 1851774590 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101265410) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 264724) |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2023-02-14 |