| NPI | 1003853508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 284241) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D63000) |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2020-12-18 |