| NPI | 1871943340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101263104) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0116029178) |
| Enumeration Date | 2016-06-15 |
| Last Update Date | 2024-07-30 |