| NPI | 1982869855 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 267568) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD60178386) |
| 207Q00000X Family Medicine (Licence: VA 0101252556) | |
| Enumeration Date | 2008-07-21 |
| Last Update Date | 2018-12-27 |