| NPI | 1932511441 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101261790) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0116026716) |
| Enumeration Date | 2014-06-02 |
| Last Update Date | 2020-09-01 |