| NPI | 1023459419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MA 266719) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 7030) |
| Enumeration Date | 2013-07-12 |
| Last Update Date | 2018-03-17 |