| NPI | 1861756470 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD174932) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0116025151) |
| Enumeration Date | 2012-06-28 |
| Last Update Date | 2023-02-08 |