| NPI | 1003176678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 34763) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ME MD16519) |
| 207Q00000X Family Medicine (Licence: GA 45100) | |
| Enumeration Date | 2012-05-17 |
| Last Update Date | 2021-06-02 |