| NPI | 1942640503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: DC MD044419) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0116025749) |
| Enumeration Date | 2013-06-27 |
| Last Update Date | 2019-08-08 |