| NPI | 1952630725 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101246589) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD481267) |
| Enumeration Date | 2009-12-08 |
| Last Update Date | 2024-09-04 |