| NPI | 1013272723 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME135723) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM MD2014-1008) |
| 207Q00000X Family Medicine (Licence: MI 4301101101) | |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2022-10-13 |