| NPI | 1861694978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101253793) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D0068811) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2022-07-26 |