| NPI | 1902806474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101058775) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101058776) |
| Enumeration Date | 2005-07-27 |
| Last Update Date | 2011-11-21 |