| NPI | 1891773107 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM MD2012-0781) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101237137) |
| Enumeration Date | 2006-01-06 |
| Last Update Date | 2019-12-04 |