| NPI | 1891872016 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101240825) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D0065265) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2011-11-19 |