| NPI | 1922072362 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101238793) |
| Additional Taxonomies | 208D00000X General Practice (Licence: VA 0101238793) |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2022-04-22 |