| NPI | 1003864760 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME55958) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME0055958) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2010-12-20 |