| NPI | 1043226822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME111746) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2006018978) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2016-11-16 |