NPI | 1033154083 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME147823) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NH 10290) |
Enumeration Date | 2006-06-16 |
Last Update Date | 2021-05-05 |